乳腺癌手术患者术前住院日和实际住院天数影响因素  

Influence Factors of the Preoperative Hospitalization Days and Actual Days in Breast Cancer Inpatients

作　　者：王锦毓 金玲芳 缪艳瑶 俞飞江[1] 胡欣[1] Wang Jinyu;Jin Lingfang;Miao Yanyao;Yu Feijiang;Hu Xin(Zhejiang Provincial Tumour Hospital, Hangzhou 310022, Zhejiang Province, China)

机构地区：[1]浙江省肿瘤医院,杭州市310022

出　　处：《中国病案》2017年第12期85-88,共4页Chinese Medical Record

摘　　要：目的分析乳腺癌手术患者术前住院日和实际住院天数,探索缩短术前住院日和实际住院天数的措施。方法分析某院2016年1月1日-2016年12月31日出院的乳腺癌手术患者的相关数据,用负二项回归模型探讨影响因素。结果术前住院日与实际住院天数相关系数0.664(P<0.001)。术前住院日影响因素为首次住院(OR=1.10,95%CI:1.03-1.17)、有转科(OR=1.32,95%CI:1.16-1.50)及存在合并症(OR=1.14,95%CI:1.08-1.21)、主手术为活检(OR=0.50,95%CI:0.41-0.59)和城镇职工医疗保险(OR=0.91,95%CI:0.84-0.98)。实际住院天数影响因素为首次住院(OR=1.13,95%CI:1.08-1.18)、有转科(OR=1.22,95%CI:1.12-1.33)、存在合并症(OR=1.08,95%CI:1.04-1.12)、辅助化疗(OR=1.20,95%CI:1.15-1.26)、病理分期(Ⅱ期:OR=1.05,95%CI:1.01-1.10;Ⅲ期:OR=1.09,95%CI:1.03-1.16;Ⅳ期:OR=1.12,95%CI:1.01-1.25)。结论术前住院日与实际住院天数有较强的相关性,可综合考虑患者的特点,缩短患者的术前等待天数,降低住院手术患者的实际住院天数。Objective Analysis preoperative hospitalization days and the actual days in hospital, to shorten preoperative hospitalization days and the actual days in hospital. Method The patients during January 1, 2016 and December 31, 2016 in the hospital with breast cancer operation were included in the study. The stay before surgery and actual days in hospital was described the Negative Binomial Regression Model was used to explore the influence factors of it. Results The correlation coefficient of preoperative hospitalization days and actual days in hospital was 0.664（P 0.001）. The influence factors of preoperative hospitalization days were the first time in hospital（OR=1.10,95% CI： 1.03-1.17）, transfer during hospitalization（OR=1.32,95% CI： 1.16-1.50）and with other complications（OR=1.14,95% CI： 1.08-1.21）, a biopsy only（OR=0.50,95% CI： 0.41-0.59）and medical insurance for urban worker（OR=0.91,95% CI： 0.84-0.98）. The influence factors of actual days in hospital were first time in hospital（OR=1.13,95% CI： 1.08-1.18）, transfer during hospitalization（OR=1.22,95% CI： 1.12-1.33）, with other complications（OR=1.08,95% CI： 1.04-1.12）, chemotherapy（OR=1.20,95% CI： 1.15-1.26）, stage of TNM（Ⅱ： OR=1.05,95% CI： 1.01-1.10;Ⅲ： OR=1.09,95% CI：1.03-1.16;Ⅳ： OR=1.12,95% CI： 1.01-1.25）. Conclusion Preoperative hospitalization days has strong correlation with the actual days in hospital. Considering the characteristics of the patients, shorten the patient＇s preoperative hospitalization days can reduce the actual days in hospital.

关 键 词：乳腺癌 术前住院日 实际住院天数 负二项回归 

分 类 号：R197.323[医药卫生—卫生事业管理] R737.9[医药卫生—公共卫生与预防医学]